The incidence of VBI increases with age and typically occurs in the seventh or eighth decade of life. Reflecting atherosclerosis, which is the most common cause of VBI, it affects men twice as often as women and is more prevalent in African Americans. Patients with hypertension, diabetes, smoking, and dyslipidemias also have a higher risk of developing VBI. And intracranial atherosclerosis is more common in individuals with black African^[1]or East Asian ethnic origin than in Caucasian populations^[2] The stroke caused by VBI account for approximately 20% to 30%21–23 of all strokes^[3] A study indicates that prevalence of >50% vertebral and basilar arterial stenosis, and vertebrobasilar arterial stenosis was more often associated with multiple ischemic episodes and a higher risk of early recurrent stroke.^[4]